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MS and Relationships

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I was gratified to see Neurology Now tackle the subject of sexuality and multiple sclerosis and honored to be interviewed for the article. This is a subject of interest and concern for men and women with MS and, unfortunately, one that doesn't often get talked about during office visits to the neurologist.

I was concerned, however, that readers might take away from this article the idea that women experience fewer—or less significant—changes in sexual function than men. The most recent studies have confirmed that women as well as men report a variety of changes in sexual function. In the most recent epidemiological study by Foley and colleagues, almost 70 percent of all respondents to the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ) reported significant sexual dysfunction. The most frequently reported problems were orgasmic difficulties (38.7 percent), erectile difficulty or inadequate vaginal lubrication (38.6 percent), and genital numbness (28.9 percent)—with no differences found between men and women on total MSISQ scores. Of particular interest was the finding that women scored higher on primary sexual dysfunction (problems directly caused by lesions in the central nervous system) and secondary sexual dysfunction (problems related to other MS symptoms or the medications used to treat them), while men scored higher on tertiary sexual dysfunction (problems related to emotional, social, and cultural issues).

Both women and men with MS should bring their concerns about sexual function to the attention of their health care providers so that they can receive the help they need.

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